Changes in prospectively collected patient-reported outcomes among women with incident endometrial cancer.

PURPOSE: We examined associations between patient and treatment characteristics with longitudinally collected patient-reported outcome (PRO) measures to provide a data-informed description of the experiences of women undergoing treatment for endometrial cancer. METHODS: We administered National Institutes of Health Patient Reported Outcomes Measurement Information System (PROMIS) questionnaires at the preoperative visit and at 6 and 12 months after surgery. Anxiety, depression, fatigue, sleep disturbance, pain, physical function, and ability to participate in social roles were assessed. Analysis of variance (ANOVA) and linear mixed models were used to examine associations between patient characteristics and PRO measures at baseline and through time. RESULTS: Of 187 women enrolled, 174 (93%) and 103 (69%) completed the 6- and 12-month questionnaires, respectively. Anxiety was substantially elevated at baseline (half of one population-level standard deviation) and returned to general population mean levels at 6 and 12 months. Younger age, Medicaid/None/Self-pay insurance, prevalent diabetes, and current smoking were associated with higher symptom burden on multiple PRO measures across the three time points. Women with aggressive histology, higher disease stage, or those with adjuvant treatment had worse fatigue at 6 months, which normalized by 12 months. CONCLUSIONS: We observed a high symptom burden at endometrial cancer diagnosis, with most PRO measures returning to general population means by 1 year. Information on risk factor-PRO associations can be used during the clinical visit to inform supportive service referral. IMPLICATIONS FOR CANCER SURVIVORS: These findings can inform clinicians' discussions with endometrial cancer survivors regarding expected symptom trajectory following diagnosis and treatment.

Aviophobia assessment: validating the Flight Anxiety Situations Questionnaire as a clinical identification measure.

An Internet survey was conducted to validate the Flight Anxiety Situations Questionnaire (FAS; Van Gerwen, Spinhoven, Van Dyck, & Diekstra, 1999) as a clinical identification measure for aviophobia. Nine hundred and seventy six people completed the survey. Using further criteria, the total pool was reduced to 98 aviophobics and 474 non-phobics. Receiver operating characteristic analysis and chi-square tests of associations indicated that minimal scores of 56 (as previously reported in research) and 70 on the FAS were useful predictors of being a flying phobic. However, the empirically derived cut-off score of 70 on the FAS had the best overall balance of Type I and Type II error, such that the diagnostic standard for flying phobia was set neither too low nor too high. Given that 60.3% of participants were university students, results may not be generalizable to the general population but may be particularly useful for researchers at these settings.